Imagine facing a surgery without anesthesia, in a smelly operating room that was not clean or sterile with a surgeon wearing a blood-stained apron. We all would run screaming out the door!

Prior to about the 1840s, that was how surgery was done. Surgeons did not wear gloves, wash their hands or sterilize instruments. Surgery was done as quickly as possible, with patients often physically held down on the table. One Victorian surgeon, Robert Liston, was renowned for amputating legs in under 30 seconds with the occasional loss of a testicle.

Four specific conditions seemed impossible to cure: hospital gangrene; blood poisoning; pyemia, a type of blood poisoning with pus-forming microorganisms in the blood resulting in abscesses; and erysipelas, a bacterial infection near the surface of the skin. Even in 1546, when Fracastro of Verona postulated that small germs could cause contagious diseases, no-one linked them to wound infections.

Louis Pasteur formed a theory that germs caused diseases, after demonstrating that microorganisms were responsible for souring wine, beer and milk. In 1862, he invented a process to kill bacteria by boiling and then cooling liquid, which we now call pasteurization. A British surgeon, Joseph Lister, built on this knowledge to change surgery forever.

Joseph Lister was born in 1827, and his father was a pioneer in the early days of microscopy. While growing up, Joseph Lister became very interested in anatomy and this led him to pursue a career in medicine, specializing in surgery. He witnessed the first surgery performed under anesthesia in 1846. In 1852, he passed his examinations and became a fellow of the Royal College of Surgeons. For his first solo operation, he repaired a woman’s intestine. He published 15 papers about the action of muscles in the skin and eyes, the coagulation of blood and the way blood vessels change with infections. He even performed a mastectomy on his sister as she lay under the influence of chloroform on his dining room table.

Though some speculated that hygiene was the reason that open wounds often led to death, most physicians still blamed noxious air that came from the wounds themselves, which could supposedly waft over and infect other patients. There was even a movement to abolish all surgery because of the high death rate from infection.

Lister read Pasteur’s work and theorized that germs caused infections. He also learned that creosote, which was used to prevent rot in wood, could also be used to disinfect sewage. With those two pieces of information, Lister began treating wounds with dressings soaked in carbolic acid derived from creosote. It worked remarkably well, all but eliminating infections on his wards. He then took further steps including hand washing, sterilization of instruments and spraying carbolic acid in the operating room during surgery. He achieved remarkable success, but he faced backlash from other physicians.

Eventually, Lister’s methods were adopted in Germany, then in the U.S., France and finally Great Britain. Joseph Lister’s methods made surgery survivable and today he is considered the “Father of Antiseptic Surgery” and he undoubtedly saved a huge number of lives.

Medical Discovery News is hosted by professors Norbert Herzog at Quinnipiac University, and David Niesel of the University of Texas Medical Branch. Learn more at www.medicaldiscoverynews.com.